Provider Demographics
NPI:1366832347
Name:SEABURG, BREA ADELE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:BREA
Middle Name:ADELE
Last Name:SEABURG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:BREA
Other - Middle Name:ADELE
Other - Last Name:FLUETSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:509-342-3758
Mailing Address - Fax:509-342-3761
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:360-791-3687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60495837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily